Community Health & Wellness Services Request

Thank you for your interest in partnering with Henry Ford Health System for your community event. Currently, our community health and wellness support services are offered at no-cost to non-profit organizations serving the community at free events.

The Henry Ford Center for Health Promotion and Disease Prevention is available for all other requests. Please visit their website for more information.

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Today's Date
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Do you have a 501 (c)3 on file? These services are for “non-profit” organizations, other entities interested can visit henryford.com/worksitewellness for information

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Organization Type (select one)









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What services are you requesting from Henry Ford Health System?



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Do attendees have to pay a registration/entrance fee?


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Date of Event
(mm/dd/yyyy)
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Number of people expected





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Who will attend this event














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Audience gender


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Additional Information (check all that apply)





Is the event targeted toward a specific racial or ethnic group?


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Will you have extension cords available for our staff?


Will the event be indoors or outdoors?


If your event is outdoors, are there plans for weather contingencies?


Do you consent to allow HFHS to list this event on our publicly-accessed community calendar?


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Please fill out the following information if you are requesting presentation services
What equipment will be available to the speaker?